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High-energy Proton Beam Therapy (PBT) commenced in England in 2018 and NHS England commissions PBT for 1.5% of patients receiving radical radiotherapy. We sought expert opinion on the level of provision. Invitations were sent to 41 colleagues working in PBT, most at one UK centre, to contribute by completing a spreadsheet. 39 responded: 23 (59%) completed the spreadsheet; 16 (41%) declined, arguing that clinical outcome data are lacking, but joined six additional site-specialist oncologists for two consensus meetings. The spreadsheet was pre-populated with incidence data from Cancer Research UK and radiotherapy use data from the National Cancer Registration and Analysis Service. 'Mechanisms of Benefit' of reduced growth impairment, reduced toxicity, dose escalation and reduced second cancer risk were examined. The most reliable figure for percentage of radical radiotherapy patients likely to benefit from PBT was that agreed by 95% of the 23 respondents at 4.3%, slightly larger than current provision. The median was 15% (range 4–92%) and consensus median 13%. The biggest estimated potential benefit was from reducing toxicity, median benefit to 15% (range 4–92%), followed by dose escalation median 3% (range 0 to 47%); consensus values were 12 and 3%. Reduced growth impairment and reduced second cancer risk were calculated to benefit 0.5% and 0.1%. The most secure estimate of percentage benefit was 4.3% but insufficient clinical outcome data exist for confident estimates. The study supports the NHS approach of using the evidence base and developing it through randomised trials, non-randomised studies and outcomes tracking. Less is known about the percentage of patients who may benefit from PBT than is generally acknowledged. Expert opinion varies widely. Insufficient clinical outcome data exist to provide robust estimates. Considerable further work is needed to address this, including international collaboration; much is already underway but will take time to provide mature data. [ABSTRACT FROM AUTHOR]

Examines the reasons of requesting x-ray examinations for acute ankle injuries in London, England. Revision on the notes and radiographs of patients with ankle injuries; Assessment on the number of radiographs of the foot requested by patients; Conclusion that the absence of clinical tissue swelling indicates that no ligamentous damage is present.

Discusses the future of Daresbury Laboratory in England as of October, 2000. Laboratory's attainment of government funding for nine collaborative projects; How Daresbury houses Great Britain's only synchrotron light source, which create X-rays to determine the structure of biological molecules; Description of the projects, including a Third Generation Proteomics project with the University of Manchester Institute of Science and Technology.

The article cites a study which reports that diagnostic likelihood of exposing the testes to radiation and are taken within one year before men father a child may have detrimental effects on the infant. Among 7,678 infants born in 1991-1992 in Avon, England, 172 had fathers who had undergone an X ray of the abdominal or pelvic area in the year before conception. The study found that these infants weighed, on average, 79 grams less at birth than those whose fathers had not had such a test. It suggest an association between men's exposure to X-rays and effects on reproductive out-comes.